Mixed Meal Simulation Model of Glucose-Insulin System

A simulation model of the glucose-insulin system in the postprandial state can be useful for studying the pathophysiology of diabetes. Here we present a new simulation model which describes the physiological events which occur after a meal, by employing the quantitative knowledge which has become available in recent years. Model parameters were set to fit data of 204 normal subjects which underwent a triple tracer meal protocol which provided quasi model-independent estimates of major glucose and insulin fluxes. Model results are shown in describing normal daily life (breakfast, lunch, dinner) both in normal and pathophysiological situations. The potential of the model for studying type 1 diabetes is illustrated by simulating both open- and closed-loop insulin infusion strategies

[1]  R. Hovorka,et al.  Nonlinear model predictive control of glucose concentration in subjects with type 1 diabetes. , 2004, Physiological measurement.

[2]  A. Cherrington,et al.  Banting Lecture 1997. Control of glucose uptake and release by the liver in vivo. , 1999, Diabetes.

[3]  C. Cobelli,et al.  Direct assessment of liver glycogen storage by 13C nuclear magnetic resonance spectroscopy and regulation of glucose homeostasis after a mixed meal in normal subjects. , 1996, The Journal of clinical investigation.

[4]  C Cobelli,et al.  The kinetics of insulin in man. I. General aspects. , 1987, Diabetes/metabolism reviews.

[5]  Claudio Cobelli,et al.  A System Model of Oral Glucose Absorption: Validation on Gold Standard Data , 2006, IEEE Transactions on Biomedical Engineering.

[6]  D Rodbard,et al.  Computer Simulation of Plasma Insulin and Glucose Dynamics After Subcutaneous Insulin Injection , 1989, Diabetes Care.

[7]  E D Lehmann,et al.  A physiological model of glucose-insulin interaction in type 1 diabetes mellitus. , 1992, Journal of biomedical engineering.

[8]  Claudio Cobelli,et al.  The hot IVGTT two-compartment minimal model: indexes  of glucose effectiveness and insulin sensitivity. , 1997, American journal of physiology. Endocrinology and metabolism.

[9]  C Cobelli,et al.  Kinetic modeling of [(18)F]FDG in skeletal muscle by PET: a four-compartment five-rate-constant model. , 2001, American journal of physiology. Endocrinology and metabolism.

[10]  John Thomas Sorensen,et al.  A physiologic model of glucose metabolism in man and its use to design and assess improved insulin therapies for diabetes , 1985 .

[11]  Ewart R. Carson,et al.  The mathematical modeling of metabolic and endocrine systems : model formulation, identification, and validation , 1983 .

[12]  Claudio Cobelli,et al.  Oral Glucose Tolerance Test Minimal Model Indexes of β-Cell Function and Insulin Sensitivity , 2001 .

[13]  Claudio Cobelli,et al.  An integrated mathematical model of the dynamics of blood glucose and its hormonal control , 1982 .

[14]  C. Cobelli,et al.  A Model of Glucose Production During a Meal , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[15]  Claudio Cobelli,et al.  Use of a novel triple-tracer approach to assess postprandial glucose metabolism. , 2003, American journal of physiology. Endocrinology and metabolism.

[16]  G. Steil,et al.  Modeling beta-cell insulin secretion--implications for closed-loop glucose homeostasis. , 2003, Diabetes technology & therapeutics.